APRIL: The TU mobilises the Theme 3 programme and seeks system agreement to this and the approach to be taken. The approach will define a shortlist and agree the priorities for the programme in 2016/17. MAY TO AUGUST: A Theme 3 Clinical Reference Group is set up and clinicians from across Greater Manchester recommend the priority projects for Theme 3. System agreement is secured for these priority projects. JULY: The TU completes the selection of a new Greater Manchester service for Oesophago-gastric and Urology cancer, which was co-designed with patients, clinicians and providers; this is assured by NHS England and approved by commissioners. This collaborative approach has since formed the template for the transformation of other prioritised services, including Vascular and Neuro-rehabilitation. SEPTEMBER: Full review, mobilisation and alignment of Theme 3 governance with the Healthier Together governance. The Healthier Together National Emergency Laparotomy Audit (NELA) dashboard goes live, meaning that levels of compliance with quality and safety standards can now be monitored and improved for patients across Greater Manchester. 5.3 GREATER MANCHESTER HEALTH & SOCIAL CARE PARTNERSHIP: STANDARDISING ACUTE AND SPECIALISED SERVICES From its inception, the TU has been commissioned to support the Greater Manchester Health & Social Care Partnership to deliver a major component of its strategic plan: Theme 3 - Standardising Acute and Specialised Services. The programme is ambitious in its scale and aims to deliver £140million in financial savings and substantial improvements to patient care across the 10 acute trusts and the wider system within the new devolved administration. The programme puts the TU at the forefront of the redesign of services in Greater Manchester, covering two thirds of all hospital activity and 61 per cent of acute costs across the conurbation (£1.6billion of £2.7billion of spend that is within the scope of the programme). The prioritised projects that are the current focus of the programme represent all key components of hospital care (medicine, surgery, women’s and children’s, and specialised services). Delivering this scale of transformation to achieve improved outcomes for patients, a financially sustainable system and managing the transition of services, while maintaining patient safety and performance, is a significant but exciting challenge, and one that the TU is ideally placed to tackle. 5.4 PENNINE ACUTE HOSPITALS NHS TRUST (PAHT) IMPROVEMENT BOARD In summer 2016, the Care Quality Commission (CQC) identified a number of failings at PAHT, subsequently returning an “inadequate” rating for the four hospitals. The TU took part in the delivery of a multi-agency risk summit and has subsequently supported the Greater Manchester Health & Social Care Partnership by managing the Improvement Board, chaired by the Chief Officer of the Greater Manchester Health & Social Care Partnership. This has included: •  Working with clinicians across Greater Manchester to develop options for the transformation of fragile services. •  Assessing how other Trusts could support PAHT through the provision of resource. •  Secretariat support (e.g. developing the Terms of Reference and involving partner agencies). •  Ensuring the programme of work required by the Improvement Board (e.g. service deep dives) is commissioned and reported upon. OCTOBER: Following work by the TU, commissioners agree that surgery for Oesophago-gastric cancers will take place in one dedicated centre for Greater Manchester - Salford Royal NHS Foundation Trust. This means that patients using this service will now be treated in a specialist centre for their surgery by specialist staff; have faster access to diagnostic tests; and will be offered the same high quality surgery service irrespective of where they live. Through Healthier Together, a national recruitment campaign is launched to attract further Emergency Medicine consultants to hospitals in Greater Manchester. NOVEMBER: Scope of work developed collaboratively between the TU and provider, commissioner, and clinical colleagues to establish how services can be transformed for the seven recommended priority projects in the scoping and design phase. DECEMBER TO MARCH: The TU mobilises a larger team to complete the first stage of design work for the seven priority projects, to develop clinical and patient standards, and clinical and financial cases for change by the end of March. JANUARY TO MARCH: The TU begins work with the new Greater Manchester Health & Social Care Partnership associate lead for Theme 3, to define the approach to develop a strategy for hospital based services that will bring all of the Theme 3 work together, engaging and involving all key system stakeholders in a clear and transparent process. 21